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General NPI Number Information
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NPI Number | 1063193936
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Entity Type | Organization
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Legal Business Name | BEAUFORT SMILES PA
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 27A KEMMERLIN LN
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City | BEAUFORT
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State | SC
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Zip | 29907-2702
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Country | US
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Telephone | 843-522-2077
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Fax |
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Provider Business Mailing Address
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Address Line | 27A KEMMERLIN LN
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City | BEAUFORT
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State | SC
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Zip | 29907-2702
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | BRITANY SACKMAN
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Credential |
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Telephone | 843-522-2077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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